Healthcare revenue cycle programs — EHR implementations with billing components, standalone RCM platform replacements, RPA deployments across claims processing — share a set of structural challenges with utility CIS modernization that neither industry tends to acknowledge. The vocabulary differs. The underlying failure modes do not.
The shared anatomy
Both are core operational systems with direct revenue impact — when they falter, the organization feels it immediately and publicly. Both touch far more organizational functions than the initial scope ever captures. Both involve vendors with strong incentives to manage the program narrative in their favor. And both surface the same unresolved conflict between IT ownership and operational ownership — the question of who actually owns the outcome when the system spans both.
Those four parallels are not coincidental. They are what happens whenever an organization replaces a revenue-critical operational system: the scope is underestimated, the stakeholder map is larger than planned, the vendor controls more of the information than the client realizes, and accountability blurs at the IT–operations seam.
Why an outside perspective helps
I bring a perspective to healthcare program governance that is not native to the industry — which means I am not carrying the assumptions that lead to the same patterns being repeated. The methodology translates directly. The questions that surface drift in a utility billing program are the same questions that surface drift in a revenue cycle transformation, because the drift has the same origins.